The Murder of Alfie Evans-Political

[Spock]

http://www.powerlineblog.com/archives/2 ... -about.php

I am sure that most here have at least heard of the death of Alfie Evans at the hands of Britain's socialized medicine system by now.

It is interesting that for all the talk of how insurance companies put a dollar and cent value on people's lives, it actually seems to be the death panels of socialized medicine systems that put a dollar value on the lives of people like Alfie.

Given the praise of Britain's National Health System by advocates of single payer socialized medicine here, I have to assume that such a system here in the US would handle our "Alfies" in a similar way.

I also suspect that under a single payer system over time, the definition of "Alfie" would tend to widen.

[jarnon]

We discussed Alfie's sad case in an earlier thread.

I can tell you from painful experience that it's often doctors who push for ending treatment of terminally ill patients, based on their idea of what's best for the patient, and hospitals have mechanisms for ensuring the patient's or family's wishes are followed without involving courts, the media or fictitious government death panels.

In America, almost all terminally ill patients are already covered by government-run insurance like Medicare and Medicaid, so British-style "socialized medicine" wouldn't make much difference.

I assume you put "murder" in the subject to get our attention. "Murder" implies that the English hospital's motivation is to save money or or adhere to an ideology that doesn't value the patient's humanity, which I doubt is the case here.

[Bob Juch]

We discussed Alfie's sad case in an earlier thread.

I can tell you from painful experience that it's often doctors who push for ending treatment of terminally ill patients, based on their idea of what's best for the patient, and hospitals have mechanisms for ensuring the patient's or family's wishes are followed without involving courts, the media or fictitious government death panels.

In America, almost all terminally ill patients are already covered by government-run insurance like Medicare and Medicaid, so British-style "socialized medicine" wouldn't make much difference.

I assume you put "murder" in the subject to get our attention. "Murder" implies that the English hospital's motivation is to save money or or adhere to an ideology that doesn't value the patient's humanity, which I doubt is the case here.

In Britan, doctors have the right to withhold life-prolonging treatment to patients without the consent of their families.

[Spock]

We discussed Alfie's sad case in an earlier thread.

I can tell you from painful experience that it's often doctors who push for ending treatment of terminally ill patients, based on their idea of what's best for the patient, and hospitals have mechanisms for ensuring the patient's or family's wishes are followed without involving courts, the media or fictitious government death panels.

In America, almost all terminally ill patients are already covered by government-run insurance like Medicare and Medicaid, so British-style "socialized medicine" wouldn't make much difference.

I assume you put "murder" in the subject to get our attention. "Murder" implies that the English hospital's motivation is to save money or or adhere to an ideology that doesn't value the patient's humanity, which I doubt is the case here.

In Britan, doctors have the right to withhold life-prolonging treatment to patients without the consent of their families.

Sorry for missing the other thread. I am busy right now with farm work, but BobJ's response still begs the question.

Given that proponents of single payer here often raise Britain's NHS as a model: Is it a good thing that doctors have that right? Would they have that right here? If not, why don't advocates of single payer say something like-"We recognize this is a weakness of the British system, but we will not do that here, because..."

in fact, I seldom, if ever, see advocates of single payer recognize that there are ANY weaknesses within the British model.

[ghostjmf]

Medicare is I believe the single-payer model in the US & I don't believe it prevents people from seeking care elsewhere.

[Bob78164]

http://www.powerlineblog.com/archives/2 ... -about.php

I am sure that most here have at least heard of the death of Alfie Evans at the hands of Britain's socialized medicine system by now.

It is interesting that for all the talk of how insurance companies put a dollar and cent value on people's lives, it actually seems to be the death panels of socialized medicine systems that put a dollar value on the lives of people like Alfie.

Given the praise of Britain's National Health System by advocates of single payer socialized medicine here, I have to assume that such a system here in the US would handle our "Alfies" in a similar way.

I also suspect that under a single payer system over time, the definition of "Alfie" would tend to widen.

This has nothing to do with socialized medicine. If that were the issue, the Vatican's offer to take the boy would have solved the problem. The issue here is that under British law under these circumstances, the government has the right to override the family's wishes. I disagree with that decision and in America the family's wishes are much more likely to be respected. As long as the family can afford to pay for the care, of course.

How do you feel about the Terry Schiavo case? --Bob

[Bob78164]

We discussed Alfie's sad case in an earlier thread.

I can tell you from painful experience that it's often doctors who push for ending treatment of terminally ill patients, based on their idea of what's best for the patient, and hospitals have mechanisms for ensuring the patient's or family's wishes are followed without involving courts, the media or fictitious government death panels.

In America, almost all terminally ill patients are already covered by government-run insurance like Medicare and Medicaid, so British-style "socialized medicine" wouldn't make much difference.

I assume you put "murder" in the subject to get our attention. "Murder" implies that the English hospital's motivation is to save money or or adhere to an ideology that doesn't value the patient's humanity, which I doubt is the case here.

In Britan, doctors have the right to withhold life-prolonging treatment to patients without the consent of their families.

Sorry for missing the other thread. I am busy right now with farm work, but BobJ's response still begs the question.

Given that proponents of single payer here often raise Britain's NHS as a model: Is it a good thing that doctors have that right? Would they have that right here? If not, why don't advocates of single payer say something like-"We recognize this is a weakness of the British system, but we will not do that here, because..."

in fact, I seldom, if ever, see advocates of single payer recognize that there are ANY weaknesses within the British model.

That's because the British model is substantially different from single-payer, but I often see conservatives fail to understand the difference between the two. In the case of many pundits and politicians, I strongly suspect the failure to understand is deliberate. On the Bored, I'm willing to assume that it's a genuine misapprehension.

Under the British model, doctors are government employees. Under single-payer, doctors are not. It's the difference between Medicare (single-payer) and the VA (British system). --Bob

[ghostjmf]

When we signed my Mom out of the hospital to, basically, die at home one of the doctors who had previously been good & helpful diagreed, but was overuled by other docs on the case. This doc's reasoning was that we wouldn't be able to manage her care at home. With the help of hospice my sister did.

What was at stake was "left against orders" or not. My Mom was on Medicare & private insurance from her job.

[ghostjmf]

By the way, I have to say I am not a big fan of hospice because of their goofy rules that they can't do anything to prolong a person's life, like give them antibiotics. I know of one person where hospice demanded they have their pacemaker removed.

What you really want is palliative care, where they make you comfortable, don't do drastic resuscitation but do leave your pacemaker in & do give antibiotics when needed. That's hard to get at home in a lot of states.

[Estonut]

That's because the British model is substantially different from single-payer, but I often see conservatives fail to understand the difference between the two.

Really? And what percentage of liberals do you estimate are able to coherently and intelligently expound on the nuanced differences between the British model and single-payer (without Google)?

[Bob Juch]

That's because the British model is substantially different from single-payer, but I often see conservatives fail to understand the difference between the two.

Really? And what percentage of liberals do you estimate are able to coherently and intelligently expound on the nuanced differences between the British model and single-payer (without Google)?

A higher percentage than conservatives. They just reject the whole idea.

[Bob78164]

That's because the British model is substantially different from single-payer, but I often see conservatives fail to understand the difference between the two.

Really? And what percentage of liberals do you estimate are able to coherently and intelligently expound on the nuanced differences between the British model and single-payer (without Google)?

Among office-holders, pretty much all of them, particularly since there’s nothing nuanced about the difference. I strongly suspect most Republican office-holders are also well aware of the difference and those who screw it up are deliberately choosing to obfuscate it. And if they don’t know the difference, they damn well should. Unlike the general public, they’re paid to be informed about these matters. —Bob

[Estonut]

That's because the British model is substantially different from single-payer, but I often see conservatives fail to understand the difference between the two.

Really? And what percentage of liberals do you estimate are able to coherently and intelligently expound on the nuanced differences between the British model and single-payer (without Google)?

Among office-holders, pretty much all of them, particularly since there’s nothing nuanced about the difference. I strongly suspect most Republican office-holders are also well aware of the difference and those who screw it up are deliberately choosing to obfuscate it. And if they don’t know the difference, they damn well should. Unlike the general public, they’re paid to be informed about these matters.

By not qualifying your statement, you implied that you often see (ALL) conservatives fail to understand the difference between the two. Your next statement specified "In the case of many pundits and politicians...," reinforcing that your prior statement was about ALL conservatives. Quite often, we here hear how dumb conservatives are, so I was wondering what percentage of run-of-the-mill liberals you think understand what you claim we dumb conservatives do not.

[Bob78164]

Really? And what percentage of liberals do you estimate are able to coherently and intelligently expound on the nuanced differences between the British model and single-payer (without Google)?

Among office-holders, pretty much all of them, particularly since there’s nothing nuanced about the difference. I strongly suspect most Republican office-holders are also well aware of the difference and those who screw it up are deliberately choosing to obfuscate it. And if they don’t know the difference, they damn well should. Unlike the general public, they’re paid to be informed about these matters.

By not qualifying your statement, you implied that you often see (ALL) conservatives fail to understand the difference between the two. Your next statement specified "In the case of many pundits and politicians...," reinforcing that your prior statement was about ALL conservatives. Quite often, we here hear how dumb conservatives are, so I was wondering what percentage of run-of-the-mill liberals you think understand what you claim we dumb conservatives do not.

"[O]ften" is a qualifier. It means that sometimes I see conservatives understand and acknowledge the difference. It's hard for me to imagine someone reading my statement as meaning that there are conservatives who understand the distinction at some times but not others.

In this particular case, I saw Spock apparently misapprehend the difference. When that misunderstanding has occurred on the Bored, I've invariably seen it among those who appear (to me, at least) to be conservative in their politics. I believe part of the explanation is that there are conservative politicians who deliberately mislead their constituents and supporters on the issue. --Bob

[Estonut]

Among office-holders, pretty much all of them, particularly since there’s nothing nuanced about the difference. I strongly suspect most Republican office-holders are also well aware of the difference and those who screw it up are deliberately choosing to obfuscate it. And if they don’t know the difference, they damn well should. Unlike the general public, they’re paid to be informed about these matters.

By not qualifying your statement, you implied that you often see (ALL) conservatives fail to understand the difference between the two. Your next statement specified "In the case of many pundits and politicians...," reinforcing that your prior statement was about ALL conservatives. Quite often, we here hear how dumb conservatives are, so I was wondering what percentage of run-of-the-mill liberals you think understand what you claim we dumb conservatives do not.

"[O]ften" is a qualifier. It means that sometimes I see conservatives understand and acknowledge the difference. It's hard for me to imagine someone reading my statement as meaning that there are conservatives who understand the distinction at some times but not others.

In this particular case, I saw Spock apparently misapprehend the difference. When that misunderstanding has occurred on the Bored, I've invariably seen it among those who appear (to me, at least) to be conservative in their politics. I believe part of the explanation is that there are conservative politicians who deliberately mislead their constituents and supporters on the issue.

I will try one last time before I give up.

Since you failed to qualify the term "conservatives" with, for example, "some," "office-holding," "politicians who are" or "the one I know IRL, " etc., you implied that you often find that conservatives (in general) fail to understand how the British model is substantially different from single-payer. Since you singled out conservatives with this, it implies that you do not feel the same is true for liberals, or you surely would have used the word "people" instead. My (simple) question to you (twice) has been, "what percentage of liberals in general do you think understand how the British model is substantially different from single-payer?"

[jarnon]

I suspect that most Americans know Britain and Canada have universal health insurance, but can’t say who the doctors work for, or how life and death decisions are made. In any case, an American single payer system would be more like Medicare and Medicaid.

[Bob78164]

By not qualifying your statement, you implied that you often see (ALL) conservatives fail to understand the difference between the two. Your next statement specified "In the case of many pundits and politicians...," reinforcing that your prior statement was about ALL conservatives. Quite often, we here hear how dumb conservatives are, so I was wondering what percentage of run-of-the-mill liberals you think understand what you claim we dumb conservatives do not.

"[O]ften" is a qualifier. It means that sometimes I see conservatives understand and acknowledge the difference. It's hard for me to imagine someone reading my statement as meaning that there are conservatives who understand the distinction at some times but not others.

In this particular case, I saw Spock apparently misapprehend the difference. When that misunderstanding has occurred on the Bored, I've invariably seen it among those who appear (to me, at least) to be conservative in their politics. I believe part of the explanation is that there are conservative politicians who deliberately mislead their constituents and supporters on the issue.

I will try one last time before I give up.

Since you failed to qualify the term "conservatives" with, for example, "some," "office-holding," "politicians who are" or "the one I know IRL, " etc., you implied that you often find that conservatives (in general) fail to understand how the British model is substantially different from single-payer. Since you singled out conservatives with this, it implies that you do not feel the same is true for liberals, or you surely would have used the word "people" instead. My (simple) question to you (twice) has been, "what percentage of liberals in general do you think understand how the British model is substantially different from single-payer?"

I can't quantify it, but this is an error I generally don't often see among liberals. The ones I've encountered have usually understood the difference. --Bob

[tlynn78]

I can't quantify it, but this is an error I generally don't often see among liberals. The ones I've encountered have usually understood the difference. --Bob

Allow me to translate, Esto:

Most liberals Bob associates with agree with him, ergo, they're correct.

[Bob78164]

I can't quantify it, but this is an error I generally don't often see among liberals. The ones I've encountered have usually understood the difference. --Bob

Allow me to translate, Esto:

Most liberals Bob associates with agree with him, ergo, they're correct.

This is a factual issue, not a matter of opinion. Britain's National Health Service is structured to make doctors government employees, as is the case with the VA here. No plan that I've heard about suggests emulating that model in the U.S. A failure to appreciate the difference between the British model and what's being proposed here is a factual error, plain and simple. But you're right that I see that factual error made far more on the right than on the left. --Bob

[Beebs52]

I can't quantify it, but this is an error I generally don't often see among liberals. The ones I've encountered have usually understood the difference. --Bob

Allow me to translate, Esto:

Most liberals Bob associates with agree with him, ergo, they're correct.

This is a factual issue, not a matter of opinion. Britain's National Health Service is structured to make doctors government employees, as is the case with the VA here. No plan that I've heard about suggests emulating that model in the U.S. A failure to appreciate the difference between the British model and what's being proposed here is a factual error, plain and simple. But you're right that I see that factual error made far more on the right than on the left. --Bob

Perhaps the nuances are too finely defined. Medicare, which I am on, requires docs, who are in the network, to abide by pay schedules and covered procedures. They may not be employed by the gummint but they are paid by the gummint, plus whatever standardized supplement one buys. And supplements are written by law.

[Bob78164]

Allow me to translate, Esto:

Most liberals Bob associates with agree with him, ergo, they're correct.

This is a factual issue, not a matter of opinion. Britain's National Health Service is structured to make doctors government employees, as is the case with the VA here. No plan that I've heard about suggests emulating that model in the U.S. A failure to appreciate the difference between the British model and what's being proposed here is a factual error, plain and simple. But you're right that I see that factual error made far more on the right than on the left. --Bob

Perhaps the nuances are too finely defined. Medicare, which I am on, requires docs, who are in the network, to abide by pay schedules and covered procedures. They may not be employed by the gummint but they are paid by the gummint, plus whatever standardized supplement one buys. And supplements are written by law.

Right. But your doctors aren't government employees. No one can tell them what treatments they can and can't offer. That's why I believe this factual difference is important.

Now it's true that Medicare can control what treatments will be paid for and how much the providers will get. But that's true whether their bills are being paid by Medicare or by private insurance. Before the Affordable Care Act, I read a lot of newspaper stories about people not getting needed medical care because their private carrier found a way, legitimate or not, to refuse to pay. I really don't remember reading those stories about Medicare.

I'm not there yet (I've got the better part of a decade before I'll be eligible for Medicare), but I'm certainly more comfortable with the payment decision being made by government than by private insurance with every financial incentive to find a reason not to pay. Governments can be moved by public pressure. With private insurance companies, it takes a lawsuit. And with the prevalence of arbitration clauses, there's a pretty good chance the "lawsuit" would actually be a private arbitration that's sheltered from public scrutiny.

By the way, most arbitration agreements are structured to allow each side to "strike" a certain number of arbitrators from the list of proposed arbitrators. Private insurance carriers are frequent repeat players. Policy holders generally aren't. That means that an arbitrator who knows which side of his bread is buttered will make every effort to avoid making a decision that ticks off the insurance company, to avoid watching his arbitration business dry up by being struck from all or most lists tendered to a specific company or its law firm. That tendency generally isn't good for the policy holder.

And of course, since Medicare doesn't need to make a profit, doesn't need to advertise, doesn't need to do medical underwriting, and doesn't pay its executives seven-figure salaries, a lot more subscriber money goes to medical care than is the case for private insurance. I'd really like to see Medicare made available for anyone who wants to opt in. --Bob